Provider Demographics
NPI:1700403557
Name:PREFERRED HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:PREFERRED HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILNLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-501-2273
Mailing Address - Street 1:17520 93RD PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-4434
Mailing Address - Country:US
Mailing Address - Phone:612-501-2273
Mailing Address - Fax:
Practice Address - Street 1:17520 93RD PL N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-4434
Practice Address - Country:US
Practice Address - Phone:612-501-2273
Practice Address - Fax:888-520-4219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA356417000Medicaid